[Carcinoid syndrome: advances in diagnosis and treatment]

Abstract

Carcinoid is the most common endocrine digestive tumor. The carcinoid syndrome resulting from the variety of amines and peptides produced by this tumor is usually apparent once there are metastases to the liver. Tumors with direct systemic venous drainage seldom produce a carcinoid syndrome without the presence of liver metastasis. This may occur because the hormone escapes the normal metabolic pathway (monoamine oxidase) in the liver. The most significant and important advance in diagnosis for tumor localization has been the introduction of scintigraphy using 111In-labeled octreotide. Current management of carcinoid syndrome should consider the spontaneous course of the disease and the severity of clinical symptoms, and includes different therapeutic options as hepatic resection, chemoembolization, medical treatment with the long-acting analogues of somatostatin and liver transplantation.